14-0343 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
14-00000343
52760 AVENIDA MONTEZUMA
773-311-002-25 -000000-
MECHANICAL
COVE RESIDENTIAL
3000
Architect or Engineer:
i\w
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT -
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business a d Professionals Code, and my License is in full force and effect.
LicenseClass: Ct2�0 License No.: 794315
Date: )1 I \ Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
(_ 1 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.).
(_ 1 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
( ) I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
1 hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name: f�
Lender's Address: \ \ t
LQPERMIT
Owner:
RICHARD NIERENBERG
52760 AVENIDA MONTEZUMA
LA QUINTA, CA 92253
(858)000-4469
Contractor:
DOVE AIR INC
69749 RISUENO ROAD
CATHEDRAL CITY, CA 92234
(760)327-1890
Lic. No.: 794315
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/31/14
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier EXEMPT Policy Number EXEMPT
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to become subject to the workers' compensation laws of California,
and agree that, if I should ecome sub'ect to the workers' compensation provisions of Section
3700 of the Labor Cod shall forth ith co I with those provisions.
Date: 3 311 �t Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this application.
1 . Each person upon whose behalf this application is made, each person at whose request and for
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not commenced
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this county to enter upon the above-mentioned property forq'sction purpos
Date:) �- r y Signature (Applicant or Agentl: A
i
Application Number . . . . . 14-00000343
Permit MECHANICAL 2013
Additional desc .
Permit Fee . . . . 11.92 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date 9/27/14
Qty Unit Charge Per
Extension
1.00 11.9200 EA MECH APPL REP/ALT
11.92
----------------------------------------------------------------------------
Special Notes and Comments
HVAC CHANGE OUT - 13SEER/78AFUE GAS PAC
UNIT [2008 ENERGY] CARBON MONOXIDE
ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING
CODES. '
----------------------------------------------------------------------------
Other Fees . . . . . . . . . PERMIT ISSUANCE M/P/E
90.57
PLAN CHECK, MECHANICAL
4.77
Fee summary Charged Paid Credited
----------------------------------------
Due
-----------------
Permit Fee Total 11.92 .00 .00
11.92
Plan Check Total .00 .00 .00
.00
Other Fee Total 95.34 .00 .00
95.34
Grand Total 107.26 .00 .00
107.26
LQPERMIT
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.-r
Bin # Cts f La. QiWlm d
Bulldin; at Safety Division
Permit # P.O. Box 104, 78.495 Calle Tampico
/ U Qulnta, CA 92253 (760). 777-7012
Building Permit Atppltradon and Tracking Sheet .
Project Address:oC I l "+d a Owner's Name 1 C `j u r r7 P- /
A. P. Number: Addrts: s D o
Legal •lhscriptiow City, ST, Zip: V i A ZZ :J
Contractor: ' j Telophone 6
Address; r Cx aP 0. Frojo6tDescAptioit: q 6
City, SP, Zip, �� a e ' C' J tiLS3 _ /C U OF
Telephone: 6 Q
state Lic. V 315 CityZlc #:
Arch., rzgr., Designer:
Address:
City; Sr, Lip:
Telcphatic:Constr �cdoa Typo: Occupancy;
,taeLie.#: Projeottyon(rirclaone): New, Add'.n i.Iter .Repay Demo
Name of Contact Person: 1 C a r N e Sq. R.: # Storics: Units:
•Telephone•# of Cornact P.erso S q .. - Esdmated Value of toed: 0
b o
APPUCANT: DO.,Nl)T;W gTE•BMOW THIS UNE
N
Submittal
Retild
Aee'd TRAM- UfG , PERMYr FEES
Plan $eta
Pian Check submitiRd Item Amount
Structural. Calm
Reviewed, ready for correedow Plan Check Deposit
Trass Calor.
Called Contact Person Plan Cheek Baiatcz
'Energy Gales.
Plias biekcd up Construction
Flood plata.plan .
Plans resubmitted Meehanleal
Grading. plan
2's Re[lew, ready for eorrectlonr/issxe Elcatrleal .
Sabcoutsctor List
Callid Contact Person Plumbing
Grant Deed
plana pi6kc4 up
li'.O.A.Approvd
' .'['lahsseaubniitled Gradidg
IN HOUSE:
eloper Impact Fee
uflR8vlew, ready for correctioraluruelist
Planning Approval
�ti Pub. ks. Appr
Fees
Called Contact Perron
Date of permit lameSchool
Penult Fees
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
52760 Avenida Montezuma La Quinta, CA 92253
City of La Quinta I
Mar 27, 2014
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
® Package Unit
❑ Furnace
❑ Indoor Coil
® AFUE 78%
® SEER 13.0
❑ COP
❑ HSPF
❑ R 6 (CZ 10-13)
R 8
Served by system
2000 sf
® Setback
If not already present, must be
[3 Condensing Unit
E3EER
[3 Resistance
[3 (CZ 14-15)
installed)
❑ Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -IR -ALT -HVAC for each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems.
HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides what work is being done
and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall
be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this
form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF -6R and registered CF -4R
forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF -111
and CF -611 shall also be on site for final inspection.
® 1. HVAC Changeout
Required Forms:
. All HVAC Equipment
CF -6R forms: MECH-04, MECH-2I-HERS
replaced
CF -4R forms: MECH-21
. Condenser Coil and /or
CF -6R forms: MECH-04, MECH-2I-HERS and (feF split systems) 04EGN 25 HERS
. Indoor Coil and /or
CF -4R forms: MECH-21 and (fee split ,.....«,,ms) MGru_-,c
. Furnace
For Packaged Units: Duct leakage < 15 percent
Exempted from duct leakage testing if:
❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or
[13. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4. The system will not be Ducted (ie. Ductless Mini -Split System) (Also Exempt from Refrigerant Charge)
❑ 2. New HVAC„System Required Forms:
. Cut in or,Changeout with CF -6R forms;`MECH-04,� M H -20 -HERS, Ind (for split systems) MECH-22-HERS, and
new ducts: (all nevJ MECH; 25=HERS �
ducting � all new -25
CF -4R forms: MECH-20, and (for split systems);MECH-22)land MECH C, w -
equipment) ,l'
350 CFM/ton, WD, TMAH, STMS, and either HSPP or PSPP.
For Split Systems:,Duct leakage 6,percent; RC, CCA >_ F
For Packaged Units Duct leakage ,'< 6 percent's '° + '• ,1� �• f ;' .,,�,�
❑ 3. New Ducts with/or without
Required Forms:
Replacement
. Includes replacing or installing all new
ducting and/or outdoor condensing unit
CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and/or furnace. No or some
CF -4R forms: MECH-20 and (for split systems) MECH-25
equipment changed.
For Split Systems: Duct leakage < 6 percent; RC, CCA 2: 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
❑ 4. New Ducting over 40 feet
Required Forms:
. Includes adding or replacing more than 40
CF -6R forms: MECH-04, MECH-2I-HERS
linear feet of duct in unconditioned space.
CF -411 forms: MECH-21
For split system or packaged units: Duct leakage < 15 percent
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
• I certify that this Certificate of Compliance documentation is accurate and complete.
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of
Compliance.
• I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the
requirements of Title 24, Parts 1 and 6 of the California Code of Regulations.
• The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance
forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application.
Name: Gary Laster Signature: Gary Laster
Company: DOVE AIR INC Date: Mar 27, 2014
Address: 68-749 RISUENO ROAD License: 794315
City/State/Zip: CATHEDRAL CITY/ CA/ 92234 Phone: (760) 327-1890
Reg: 214-A0021539A-000000000-0000
2008 Residential Compliance Forms
Registration Date/Time: 2014/03/27 18:36:03 HERS Provider: Ca10ERTS, Inc.
July 2010